title: [Preoperative CT Scan in middle ear cholesteatoma].
abstract: OBJECTIVE
  To compare preoperative CT scan finding and per-operative lesions in patients operated for middle ear cholesteatoma,
  
  
  METHODS
  A retrospective study including 60 patients with cholesteatoma otitis diagnosed and treated within a period of 5 years, from 2001 to 2005, at ENT department of Military Hospital of Tunis. All patients had computed tomography of the middle and inner ear. High resolution CT scan imaging was performed using millimetric incidences (3 to 5 millimetres). All patients had surgical removal of their cholesteatoma using down wall technic. We evaluated sensitivity, specificity and predictive value of CT-scan comparing otitic damages and CT finding, in order to examine the real contribution of computed tomography in cholesteatoma otitis.
  
  
  RESULTS
  CT scan analysis of middle ear bone structures shows satisfaction (with 83% of sensibility). The rate of sensibility decrease (63%) for the tympanic raff. Predictive value of CT scan for the diagnosis of cholesteatoma was low. However, we have noticed an excellent sensibility in the analysis of ossicular damages (90%). Comparative frontal incidence seems to be less sensible for the detection of facial nerve lesions (42%). But when evident on CT scan findings, lesions of facial nerve were usually observed preoperatively (spécificity 78%). Predictive value of computed tomography for the diagnosis of perilymphatic fistulae (FL) was low. In fact, CT scan imaging have showed FL only for four patients among eight. Best results can be obtained if using inframillimetric incidences with performed high resolution computed tomography.
  
  
  CONCLUSIONS
  Preoperative computed tomography is necessary for the diagnosis and the evaluation of chronic middle ear cholesteatoma in order to show extending lesion and to detect complications. This CT analysis and surgical correlation have showed that sensibility, specificity and predictive value of CT-scan depend on the anatomic structure implicated in cholesteatoma damages.
authors.affiliation: Service d'ORL et de chirurgie maxillo-faciale, Hôpital principal d'instruction militaire, Tunis.
authors.forename: Anissa
authors.initials: A
authors.lastname: Sethom
authors.forename: Khemaies
authors.initials: K
authors.lastname: Akkari
authors.forename: Inès
authors.initials: I
authors.lastname: Dridi
authors.forename: S
authors.initials: S
authors.lastname: Tmimi
authors.forename: Ali
authors.initials: A
authors.lastname: Mardassi
authors.forename: Sonia
authors.initials: S
authors.lastname: Benzarti
authors.forename: Imed
authors.initials: I
authors.lastname: Miled
authors.forename: Mohamed Kamel
authors.initials: MK
authors.lastname: Chebbi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000209:etiology; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult